Stephanie E Wilson, M.D.

Primary specialty

Aerospace Medicine PhysicianTaxonomy code 2083A0100X

License

055716 Issued in GA

Practice address

243 Curtiss Rd Ste 100
Barksdale AFB, LA 71110-2425

Phone

(318) 456-6555

NPI assigned

Sep 29, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680220800000",
    "number": "1235221946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7110 EDEN CT",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302962159",
            "telephone_number": "770-761-0672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "243 CURTISS RD STE 100",
            "city": "BARKSDALE AFB",
            "state": "LA",
            "postal_code": "711102425",
            "telephone_number": "318-456-6555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "STEPHANIE",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-29",
        "last_updated": "2023-03-31",
        "certification_date": "2023-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083A0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Aerospace Medicine",
            "state": "GA",
            "license": "055716",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "055716",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brenda White, REGISTERED NURSE
• Brian Michael Whitenack
• Adrienne S. Williams, PHARMD
• Brandy Shannon Williams, PA-C
• Rachonn Shalette Williamson, IDMT
• Sylvia Jean Wimberly, LCSW
• Tomekia Wynn
• Amie Zavala

• Aerospace Medicine Physician in Barksdale AFB, LA
• Providers in Barksdale AFB, LA by specialty
• Aerospace Medicine Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.